White Oak Medical Clinic LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WHITE OAK MEDICAL CLINIC LLC

Doing business as

White Oak Medical Center

Practice address

340 NW Medical Loop
Roseburg, OR 97471-1645

Phone

(541) 464-5907

NPI assigned

May 22, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Diane BolducNPI 1174537047

Title

President

Phone

(541) 464-5907

Specialties & licenses 3

Addresses

Other names 1

• White Oak Medical Center Doing business as

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CFGBCD

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Diane Bolduc, M.D.

  • Family Medicine Physician
  • Roseburg, OR
  • NPI 1174537047
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1747872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1043003114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 NW MEDICAL LOOP",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711645",
            "telephone_number": "541-464-5907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 NW MEDICAL LOOP",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711645",
            "telephone_number": "541-464-5907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE OAK MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-22",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "BOLDUC",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-464-5907"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "White Oak Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Justin Wheaton, QMHA
• Trina Wheeldon
• Gary E Wheeler, MD
• Shea Leigh Wheeler, QMHA
• Mackenzy James Whetzel, PSS
• White Oak Medical Clinic LLC
• Alexandra White, AUD
• David H White, DMD
• Trevar John White
• Rachael Whiteberg

• Family Medicine Physician in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.